HIV and Sexually Transmitted Infections Among Persons with Monkeypox — Eight U.S. Jurisdictions, May 17–July 22, 2022
Authors: Kathryn G. Curran, Kristen Eberly, Olivia O. Russell, Robert E. Snyder, Elisabeth K. Phillips, Eric C. Tang, Philip J. Peters, Melissa A. Sanchez, Ling Hsu, Stephanie E. Cohen, Ekow K. Sey, Sherry Yin, Chelsea Foo, William Still, Anil Mangla, Brittani Saafir-Callaway, Lauren Barrineau-Vejjajiva, Cristina Meza, Elizabeth Burkhardt, Marguerite E. Smith, Patricia A. Murphy, Nora K. Kelly, Hillary Spencer, Irina Tabidze, Massimo Pacilli, Carol-Ann Swain, Kathleen Bogucki, Charlotte DelBarba, Deepa T. Rajulu, Andre Dailey, Jessica Ricaldi, Leandro A. Mena, Demetre Daskalakis, Laura H. Bachmann, John T. Brooks, Alexandra M. Oster, Michael Abassian, Meaghan Abrego, David Addo, Bridget J. Anderson, Connie Austin, Kailey Bradley, David Bui, Shua Chai, Eric Chapman, Joseph Clement, Catherine Comis, Phoebe Danza, Marisa Donnelly, Kerri Dorsey, Kate Drezner, Alicia Dunajcik, Areesh Fatmee, Amanda Feldpausch, Lauren Finn, Rebecca Fisher, Kameron Gadawski, Jasmine Gaillard, Varun Gandhi, Amy Garlin, Sarah Gillani, Jamilla Green, Megan Hill, Taylor Holly, Virginia Hu, Otto Ike, Anna Satcher Johnson, Kelly Johnson, Janna Kerins, David Kern, Bita Khoshhal, Akiko Kimura, Irma Kocer, Colin Korban, Chun-Mai Kuo, Rodriques Lambert, Issa Lee-Hall, Jessica Lorenzo-Luaces, Elise Mara, Amy Marutani, Karla Miletti, Wilson Miranda, Allison Morrow, Dawn Nims, Melissa Ongpin, Chisom Onyeuku, Jessica Pavlick, Eugene Pennisi, Neela Persad, Mary Pomeroy, Kathleen Poortinga, Dylan Atchley Procter, Marisa Ramos, Eli Rosenberg, Lori Saathoff-Huber, Nannie Song, Dan Stowell, Deanna Sykes, Amanda Terminello, Ebony Thomas, Chris Toomey, Brittany Wilbourn, Tanya Williams, Pascale Wortley
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

High prevalences of HIV and other sexually transmitted infections (STIs) have been reported in the current global monkeypox outbreak, which has affected primarily gay, bisexual, and other men who have sex with men (MSM) (1-5). In previous monkeypox outbreaks in Nigeria, concurrent HIV infection was associated with poor monkeypox clinical outcomes (6,7). Monkeypox, HIV, and STI surveillance data from eight U.S. jurisdictions* were matched and analyzed to examine HIV and STI diagnoses among persons with monkeypox and assess differences in monkeypox clinical features according to HIV infection status. Among 1,969 persons with monkeypox during May 17-July 22, 2022, HIV prevalence was 38%, and 41% had received a diagnosis of one or more other reportable STIs in the preceding year. Among persons with monkeypox and diagnosed HIV infection, 94% had received HIV care in the preceding year, and 82% had an HIV viral load of <200 copies/mL, indicating HIV viral suppression. Compared with persons without HIV infection, a higher proportion of persons with HIV infection were hospitalized (8% versus 3%). Persons with HIV infection or STIs are disproportionately represented among persons with monkeypox. It is important that public health officials leverage systems for delivering HIV and STI care and prevention to reduce monkeypox incidence in this population. Consideration should be given to prioritizing persons with HIV infection and STIs for vaccination against monkeypox. HIV and STI screening and other recommended preventive care should be routinely offered to persons evaluated for monkeypox, with linkage to HIV care or HIV preexposure prophylaxis (PrEP) as appropriate.